You want Obamacare? Get ready to pay through the nose.

[agamemnus]

So, one of my parents got a moderate gash in the hand because of broken glass. The local hospital charged $445 to a private insurer for two visits. The final cost a $50 copay for both visits.

I would have paid much less if I had that gash, because I'm on the free public insurance. The hospital would not have gotten this enormous compensation, effectively.

This is Massachusetts. Obamacare will probably be just as terrible in inflating costs and marginalizing insurer "bargaining" power to the point that the hospital (or clinic, or what have you) can charge absurd amounts for relatively miniscule operations. How does this save money?

[Hazir]

I read this, then decided it wasn't really worth replying.

[Dreadnaught]

I don't even follow what's going on here...but a judge sez Obamacare is unconstitutional so the fight goes on.

[Hazir]

I wouldn't put any money on the SC scrapping 'Obamacare'. I do predict that once it is going to kick in it will become politically expedient to put pressure on care providers to provide care at more economic prices.

[Dreadnaught]

Unfortunately the law leaves that up to the insurance companies more than healthcare providers...

[Being]

I wonder how many states are concerned about the standing of their auto insurance laws after this latest court ruling on mandated insurance?

[Dreadnaught]

Probably not worried. Unlike breathing, driving isn't compulsory (see:Amish).

[agamemnus]

Sorry, I should have been more clear. The $445 was covered by the insurance company, but $50 was not.

Haven't listened to the Florida ruling... I don't see the big deal, since it'll all be decided in the Supreme Court anyway.

[Being]

Probably not worried. Unlike breathing, driving isn't compulsory (see:Amish).

Umm...living (in the US) isn't compulsory either.

[GGT]

So, one of my parents got a moderate gash in the hand because of broken glass. The local hospital charged $445 for two visits. Because of private insurance, it only cost a $50 copay for both visits.

That's what the hospital charged--not the cost of care. Your parents paid $100 OOP, but I doubt their insurance reimbursed the full $345, because of their group bargaining powers.

I would have paid much less if I had that gash, because I'm on the free public insurance. The hospital would not have gotten this enormous compensation, effectively.

Nothing is "free", so you'll have to describe this public insurance of yours. Do you mean MassCare or Medicaid?

This is Massachusetts. Obamacare will probably be just as terrible in inflating costs and marginalizing insurer "bargaining" power to the point that the hospital (or clinic, or what have you) can charge absurd amounts for relatively miniscule operations. How does this save money?

Providers already charge at escalating rates. This wasn't even Insurance Reform, not really.

Probably not worried. Unlike breathing, driving isn't compulsory (see:Amish).

Amish hitchhike and take buses (from the insured). Many sects carry insurance for their horse and buggies, because they're involved in car-buggy crashes. They're not exempt from being sued.

[agamemnus]

No, no. The insurance company sent a letter showing how much money they sent to the hospital -- $445. My parents paid the hospital $50 total for both the initial visit and the follow-up. That's $495 to the hospital for, I believe, 7 stitches.

I don't know about other states without public health insurance, but I have a suspicion that their rates aren't quite so high.

The Massachusetts public health insurance is free (on a monthly basis) for low-income earners or people who are unemployed. It's called MassHealth, and I qualify for it. I think there is a copay but it is very low. Not every health provider participates in it though.. some can opt out. My dentist does not participate, for example.

My regular doctor does; unfortunately, they have been publicly advertising and accepting new (probably mostly massHealth) patients for several months now. The normal (normal for about ~10 years) 30 minute to 1-hour wait for a 2-minute visit with the doctor to get him to write a prescription is now 1 hour to 2 hours. Who, with a private insurance, will opt to go to a small clinic where they are rude and take 2+ hours for a 2 minute visit, instead of going to one where they are courteous and take you right away (and they probably don't accept MassHealth)?

However: the hospital, I believe, does accept MassHealth, and they are apparently very fast and courteous. I think it's not a problem for hospitals, as opposed to clinics, as they can apparently get away with charging enormous sums for relatively simple services that only they can offer in a timely fashion. (parents first went to clinic and got rudely turned away -- told to wait 1 hour for the gash treatment --, then went to hospital ER)

[GGT]

No, no. The insurance company sent a letter showing how much money they sent to the hospital -- $445. My parents paid the hospital $50 total for both the initial visit and the follow-up. That's $495 to the hospital for, I believe, 7 stitches.

Depends on billing and receipts. Anyway, one reason care is expensive is because of low co-pays. Also group bargain deals for big insurers. Providers just shift the money around.

The Massachusetts public health insurance is free (on a monthly basis) for low-income earners or people who are unemployed. It's called MassHealth, and I qualify for it. I think there is a copay but it is very low. Not every health provider participates in it though.. some can opt out. My dentist does not participate, for example.

It might be no cost for you, but it's not Free. Mass. residents pay for it somehow. That's Romney's plan, right?

[agamemnus]

I added some more storyline above, sorry for the constant editing. Anyway, the $50 isn't low in my opinion, but if the copay pricing scheme is mandated then it would be that way, I guess. Anyway, the point is that the $495, let alone the $50, is a lot, whichever way you slice it. I was mildly surprised when I heard $50; when I saw the insurance company letter, I was shocked.

Edit:

And yes, it's paid on the taxpayer's dime, obviously. But the problem is that apparently it raises the price for everyone else big time.. just like federal tuition grants to low-income students and their parents raise the price of tuition for everyone else.

Edit 2:

In the case of health insurance, if you do national health insurance all at once you'll be making a huge supply/demand imbalance. You'll have the same amount of doctors and facilities, but you want them to treat more patients. They'll just raise everyone's rates and force some people (who are paying) to come to the doctor less. This will change in time with supply catching up to demand, but terrible government payment schemes will emerge, creating perpetual inefficiencies in the system.

[Dreadnaught]

Umm...living (in the US) isn't compulsory either.

So I take it you support mass forced deportations of Mexican immigrants? After all, they are breaking laws that don't make sense.

Amish hitchhike and take buses (from the insured). Many sects carry insurance for their horse and buggies, because they're involved in car-buggy crashes. They're not exempt from being sued.

Indeed, but I don't think we force them to carry insurance, do we? Taking a bus doesn't count, insurance is part of the fare.

Candidly, I'm jealous of the Amish ability to opt-out of Medicare and SS.

[GGT]

I added some more storyline above, sorry for the constant editing. Anyway, the $50 isn't low in my opinion, but if the copay pricing scheme is mandated then it would be that way, I guess. Anyway, the point is that the $495, let alone the $50, is a lot, whichever way you slice it. I was mildly surprised when I heard $50; when I saw the insurance company letter, I was shocked.

A flat co-pay doesn't make any sense IMO. Some say the same about flat-rate deductibles, too. $50 co-pay for some stitches shouldn't be on par with $50 co-pay for an appendectomy. Point being that people don't pay enough of their "own money" into the system, so they have no clue about costs. They just leave it to insurance and/or employers, then wonder why premiums go up 20% every quarter.

And yes, it's paid on the taxpayer's dime, obviously. But the problem is that apparently it raises the price for everyone else big time.. just like federal tuition grants to low-income students and their parents raise the price of tuition for everyone else.

Cost-shifting, that's what they do.

In the case of health insurance, if you do national health insurance all at once you'll be making a huge supply/demand imbalance. You'll have the same amount of doctors and facilities, but you want them to treat more patients. They'll just raise everyone's rates and force some people (who are paying) to come to the doctor less. This will change in time with supply catching up to demand, but terrible government payment schemes will emerge, creating perpetual inefficiencies in the system.

Nothing in the US happens all at once. We've been tinkering around with this for decades.

[GGT]

Indeed, but I don't think we force them to carry insurance, do we? Taking a bus doesn't count, insurance is part of the fare.

Not sure, probably depends on the county and township rules. Taking a bus counts as paying insurance, because they don't ride free. Same for trains and planes.

Candidly, I'm jealous of the Amish ability to opt-out of Medicare and SS.

They have a whole different culture for caring for their elderly, though. Entirely different attitude toward English medicine.

Some self-insured employers may try to opt-out, but no idea if or how that works. My employer tried that years ago and the state supreme court ruled it was illegal to opt-out.

[Lewkowski]

At least for right now Obama Care has ceased to exist...

[Ziggy Stardust]

At least for right now Obama Care has ceased to exist...

\Yay! More taxes

Don't take my word for it, the reps themselves admitted as much with their Pay-Go plans.

http://www.thedailyshow.com/watch/th...-the-new-batch

6:15 in.

[GGT]

\Yay! More taxes

Don't take my word for it, the reps themselves admitted as much with their Pay-Go plans.

http://www.thedailyshow.com/watch/th...-the-new-batch

6:15 in.

I hadn't seen that episode. Captain Blubberpants and Pseudo nip 3,000!

[GGT]

At least for right now Obama Care has ceased to exist...

No, it hasn't. Only a few mandates have taken effect. In general, people like the initial changes to health insurance, especially the non-discrimination of pre-existing conditions, lifetime caps, and children up to age 26. Most changes aren't scheduled until 2014.


<I received a form letter from my insurance company, explaining the new law and how it affects me. I was surprised by their explanation of children over the age of 18, though. If they were part of my previous plan, but were cancelled for age/student/pre-existing status, they can be added again. But it's under a Grandfather clause. I take that to mean that I can't just add my 19 year old son as a new member on my plan. That's rather screwy and counterintuitive to the goal of the bill.>

[GGT]

I'm trying to figure out the term "unseverable". This latest judge says the individual mandate means the whole bill is voidable.

Isn't that kind of like saying SS and Medicare are unconstitutional because certain groups like the Amish aren't required to contribute?

[Lewkowski]

No, it hasn't.

Yes it has. The judge ruled the entire thing voidable. Until that decision is overturned that is the official law of the land. I'm sure the SC will eventually rule on it and I'm thinking that the mandated insurance coverage will the void but the rest will stay but for right now I think its pretty hilarious.

[Dreadnaught]

The judge ruled that the law must be overturned entirely because of how the law was designed, but he issued a stay in that part of his ruling pending the appeals process because he knows this thing is heading to the Supreme Court. It's still the law, but a judge has found it unconstitutional.

[agamemnus]

Nothing in the US happens all at once. We've been tinkering around with this for decades.

I think you know what I mean, but just to clarify I meant "if it is instituted everywhere are once...".

[Hazir]

Unfortunately the law leaves that up to the insurance companies more than healthcare providers...

If insurers can't bring themselves to be cost consious, then premiums will have to go up excessively and more people will qualify for some type of support in order to be able to buy this compulsary insurance, which means tax money is involved.

That's when politicians will have to start acting. Or not of course, in which case the US will have a double digit deficit on a fixed basis. Which in return will make US healthcare very affordable for foreigners, but no so much so for Americans.

[Dreadnaught]

Separately, this is embarrassing...

http://www.youtube.com/watch?v=9shGzvP1Jho

[GGT]

Why would that be embarrassing? Obama didn't write the healthcare bill, congress did. I think he wanted a public option, but that fell apart. In '08 everyone wanted to control rising costs.....nobody has really done a damn thing about that. That's what's embarrassing for us, as a country.

[Hazir]

Why would that be embarrassing? Obama didn't write the healthcare bill, congress did. I think he wanted a public option, but that fell apart. In '08 everyone wanted to control rising costs.....nobody has really done a damn thing about that. That's what's embarrassing for us, as a country.

Don't worry, that part will come automatically. Also I doubt this law is going to fall through in the end.

[Dreadnaught]

Why would that be embarrassing? Obama didn't write the healthcare bill, congress did. I think he wanted a public option, but that fell apart. In '08 everyone wanted to control rising costs.....nobody has really done a damn thing about that. That's what's embarrassing for us, as a country.

His political team was certainly involved, he certainly signed it, his justice department has been defending it and he's certainly staked his personal reputation on the wisdom of the individual mandate.

Guess what? Obama is a politician. Looks like he's human after all.

[GGT]

His political team was certainly involved, he certainly signed it, his justice department has been defending it and he's certainly staked his personal reputation on the wisdom of the individual mandate.

Guess what? Obama is a politician. Looks like he's human after all.